Oct. 25, 2021 — Theranos, once valued at more than $9 billion dollars, seemed like it was going to revolutionize routine blood testing. Their claim was revolutionary. They could run over 200 tests using blood taken from a finger prick. A trip to the local pharmacy could allow someone to get testing done without having to draw blood and have the results within hours instead of days. Theranos stated that dozens of tests could be run with just one drop of blood. These tests would also cost less than traditional lab work.
Theranos’s house was a mess, but it fell down. The microwave-sized machine, known as the “Edison,” that was supposed to be able to run these tests, simply didn’t work. It was not surprising that Silicon Valley and the investment community were shocked by the results.
Sheldon Campbell, MD and PhD, a Yale School of Medicine professor of laboratory medicine, said, “It was like claiming you could build an airplane that is also a sub-marine, for the same cost as an entry-level Toyota.”
Campbell says that blood analysis progress is slower than in computing technology. One breakthrough can transform the entire field. Although hybrids and electric cars have been developed by the automotive industry, the fundamentals of a car’s construction have not changed.
He says, “The drivetrains haven’t changed, and tires haven’t changed.” It’s a mature technology.
The process of blood testing is also evolutionary and not revolutionary.
The technician will use a needle to draw blood from your arm into a tube. Each tube holds between 1/2 and 1 teaspoon of blood. Depending on how many tests you ordered, the technician may fill several tubes during the draw. This gives lab technicians plenty of material to work with. Doctors can also request additional tests after a sample has been taken.
Half of blood is composed of red and white blood cells. The other half is liquid. The liquid portion of most diagnostic tests is used. This means that only half of a standard specimen can be used for testing. Although it is possible to use blood from a finger prick (also known as a capillary specimen) for testing, it can be more difficult. These small samples, which are a few drops of blood, are 30 to 100x smaller than a standard blood draw. Capillary blood is not taken directly from the vein. Instead, it is mixed with liquids from tissues. This can lead to an inaccurate result.
A small amount of blood from one finger is sufficient for simple tests such as checking glucose levels (something that diabetics do multiple times per day). The most advanced glucose monitors can produce accurate results using a fraction of the blood required for a typical capillary sample.
Kimberly Sanford MD, president of American Society of Clinical Pathology, says, “You can literally take the capillary sample and place it on your test strips. This simple chemical reaction takes place inside the testing chamber so you can get a glucose reading.”
Sanford says that it is more difficult to move more complex tests, which require multiple chemical reactions, out of central laboratories into clinics. Multiple tests that require only a few drops blood can present additional engineering challenges because each test requires a specific amount of blood.
Point-of-care testing is also known as diagnostic testing outside the lab. It is more expensive than testing in a central lab. Point-of-care testing, on the other hand, is performed one at a while. Larger labs can handle multiple samples at once.
The tests must be quick, easy, and accurate to get the most bang for your buck. It is more practical to send samples to a laboratory than to perform in-office tests unless they can provide the clinicians with all the information they need for a medical decision.
Campbell states that “no point of care test is more complicated than checking off another box on a laboratory order form.”
Despite these obstacles, laboratory testing has been making its way to clinics and bedside services.
“They’re similar technologies as what we would use on the main laboratory’s larger analyzers, however they miniaturize them to make them more portable,” said James H. Nichols PhD, a professor in pathology, microbiology and immunology at Vanderbilt University Medical Center.
Microfluidics, which is a system that processes very small amounts of liquid to test for diagnostic purposes, has made it possible to run multiple diagnostic checks on a few drops blood. However, not as many as Theranos promised.
The i-STAT handheld blood analyzer by Abbott Laboratory can provide multiple results from a standard finger-prick sample. With just a few drops blood, the Chem 8+ cartridge can provide results for nine metabolic measurements. The user must place two to three drops of whole blood onto the test cartridge. After that, the cartridge is inserted into the analyzer. Each patient receives a new test cartridge.
An Abbott spokesperson stated that the i-STAT provides accurate lab-based testing for blood gases and electrolytes, chemistries as well as coagulation, glucose, and cardiac markers. Results are available within 2 minutes.
Nichols states that the device was originally designed for urgent care, but it can also be used at health fairs, medical tents at events and other mobile care settings.
There are a few tabletop blood chemistry testers that can perform the same types of tests for both outpatient and emergency care. Piccolo Xpress is a portable analyzer that can perform up to 14 tests on a finger-prick of blood. It delivers results in just 12 minutes.
Nichols states that complete blood counts, which are a group of tests that count white blood cells, red cells and platelets, are now being offered in primary care and other outpatient clinics. A clinician can obtain results in three minutes or less by using a few drops.
Nichols predicts that there will be more infectious disease testing moving out of the main laboratory into the community. This is partly due to the importance COVID-19 rapid testing. He says that developing more rapid and easy-to-use tests to detect diseases such as dengue fever and malaria, which are more common in developing countries, could improve access to laboratory diagnostics.
Campbell states that “it’s going to an evolutionary process” as laboratory testing continues to be adapted to more portable and rapid technologies. It will work in both directions. He said that the point-of care market is expanding and people are coming up creative ideas and ways to do it at point-ofcare. However, the lab-based side will not be static. They will grow towards each other.
WebMD Health News
Sheldon Campbell, MD and PhD, is a professor of laboratory medicine at Yale School of Medicine.
Kimberly Sanford MD, president, American Society of Clinical Pathology.
James H. Nichols PhD, professor of pathology and microbiology at Vanderbilt University Medical Center in Nashville.
Abbott: “Lab-Quality Diagnostic Testing Without Waiting”
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Original Post: webmd.com
New GR Pharmacy to Serve Spanish-speaking Patients
GRAND RAPIDS, Mich. (WOOD) — By the end of the year, Grand Rapids’ Roosevelt Park neighborhood will have a new pharmacy.
Trinity Health Clinica Santa Maria began construction Monday morning on the $1.5 million project. The new pharmacy will include both walk-up and drive-thru services.
Trinity Health Clinica Santa Maria practice leader Kameron Selleck it will offer convenience in a neighborhood that doesn’t have a pharmacy close in proximity, making it challenging for patients to get their prescriptions in a timely manner.
“A lot of our patients do encounter a lot of social barriers in their lives,” Selleck said.
He added that a language barrier can make it difficult patients to get their prescriptions. He said nearly every employee at Clinica Santa Maria is bilingual in Spanish and the plan is for that trend to carry over to new pharmacy and pharmacy tech hires.
“I think this project was announced almost five years ago, so it’s here,” Selleck said. “I just really encourage the community to be as excited as we are.
The pharmacy is at 730 Cesar E. Chavez Ave. SW (formerly Grandville Avenue) at Martin Luther King Jr. Street (formerly Franklin Street) in Grand Rapids. It will be the seventh Trinity Health pharmacy in the Grand Rapids area, with the other locations being Cathedral Square, the Wege Building at Trinity Heath Saint Mary’s, Hudsonville, Rockford, Byron Center and Southeast Grand Rapids.
Original Post: woodtv.com
Tulip Time Crowds Encouraging for Returning Festivals
HOLLAND, Mich. (WOOD) — Tulip Time saw big crowds this year as it returned to a more regular schedule.
The event was cancelled in 2020 and scaled back last year because of the pandemic.
The heat caused challenges for the 2022 festival. The Tulip Immersion Garden, a new attraction, had to close early because the hot temperatures caused too much damage to the flowers, Tulip Time Executive Director Gwen Auwerda said.
“They don’t like 80 degree, 90 degree weather. Tulips prefer it to be about 40 at night, 60 to 70, maybe 80 during the day,” Auwerda said.
The organization is working on final numbers but saw attendance return to pre-pandemic levels.
“I do know that the carnival exceeded 2019 by 25 to 30%, so that was fabulous for them and it was packed everywhere in town,” Auwerda said.
Kevin Knight, the owner of Market Zero, said the festival definitely provided a boost as they worked to keep up with demand.
“It’s a huge kick off to your summer season,” Knight said. “Our fridges were completely full and got completely empty and completely full and completely empty, so it was about everything we could handle.”
Market Zero in downtown Holland on May 16, 2022. Inside Market Zero in downtown Holland on May 16, 2022.
The return of crowds could be good sign for other events coming back this summer, like the Festival of the Arts in Grand Rapids. Mark Azkoul, an organizer for the event that began in 1970, sees the success of Tulip Time as encouraging.
“We’ve been out for two years so this is a big thing for us and for the city to get Festival back up and going,” Azkoul said.
Organizers created the Plein Air event for 2021, which combined outdoor art and music.
The 2022 event runs June 3 through June 5. After taking a break because of the pandemic the festival needs extra help.
“A lot of people still don’t know yet festival is coming back, so we really want to get the word out. We need more volunteers,” Azkoul said.
People interested in volunteering can sign up on the Festival of the Arts website.
Mom Does ‘small Part’ to Help Parents Who Need Formula
HOLLAND, Mich. (WOOD) — Though there appears to an end of the baby formula shortage in sight, it’s still causing problems for parents, so a mother in Holland did what she could to help.
Abbott Nutrition has announced its entered into an agreement with the federal Food and Drug Administration to restart its Sturgis plant within two weeks. The closure of that plant has been a huge contributing factor to the shortage. The company expects its products to ship to stores eight weeks after production resumes.
But for now, many parents can’t find the formula they need. The low supply has some stores limiting the number of formulas customers can purchase, adding that they are in “extraordinary high” demand.
The baby formula shelves at a Meijer in Holland.
So Caitlin Dampier, a mother of two whose youngest is a 3-month-old girl, stepped up to help where she could.
“I really wish I could help out more, but this is just my small part,” Dampier said.
She got a box of Enfamil formulas that she’s not using because she’s breastfeeding.
“When you’re pregnant, you get free samples and so I thought I would just offer mine for free for mothers who need them,” Dampier said. “I kept it around in case I wasn’t able to breastfeed.”
Dampier made a post on Facebook this week directed at parents who can’t find formula. The box she received included three cans of Enfamil formulas and two ready-made formulas.
Two mothers reached out to her, including Kourtney Hann, another Holland resident. She’s one of thousands of mothers across the country who have had to go to great lengths to find food for their baby.
“I have had to go to stores maybe 45 minutes away just to even try to get formula,” she said. “It’s very hard to find them where I’m at right now. I went to Walmart yesterday and all they had was Similac and my daughter has a really bad reaction to Similac.”
Hann was able to connect with Dampier and picked up a can of Enfamil. Dampier left the box on her front porch with the message, “Please take only the formula you chose and tear out some coupons for yourself. My prayers are with you during this difficult time.”
The box of Enfamil products Caitlin Dampier left at her door for mothers to pick up.
Hann said she was down to her last can of baby formula which lasts her about five days. Now that she has received another can from Dampier, she’ll be able to feed her 9-month-old for the next two weeks.
“Being a mom is hard enough as it is. You have so many other struggles and to be afraid to know if you’re going to be able to feed your baby or not is a struggle,” Dampier said. “You want to do everything for your kids so when you’re not able to it’s hard. It’s just the worst feeling in the world.”
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